• Humans
• Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods
• Female
• Male
• Middle Aged
• Lymphadenopathy/pathology
• Lymphadenopathy/genetics
• Aged
• Adult
• Lymph Nodes/pathology
• Retrospective Studies
• Aged, 80 and over
• Needles
• Genomics/methods

• Humans
• Female
• Middle Aged
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/therapy
• Esophageal Squamous Cell Carcinoma/pathology
• Esophageal Squamous Cell Carcinoma/therapy
• Esophageal Squamous Cell Carcinoma/surgery
• Endoscopic Mucosal Resection
• Diagnosis, Differential
• Deglutition Disorders/etiology
• Leiomyoma/pathology
• Leiomyoma/diagnostic imaging
• Leiomyoma/surgery

• 20192BAB215034 Science and Technology Department of Jiangxi Province
• 81401983 National Natural Science Foundation of China
• 202310393 Scientific Research of Health Commission of Jiangxi Province
• JJ210230 Education Department of Jiangxi Province

• Humans
• Endosonography/methods
• Endosonography/instrumentation
• Equipment Design
• Ultrasonography, Interventional/methods

• Humans
• Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects
• Pancreatitis/etiology
• Pancreatitis/epidemiology
• Pancreatic Cyst/pathology
• Pancreatic Cyst/diagnostic imaging
• Risk Factors
• Risk Assessment

• biopsy
• diagnostic accuracy
• endoscopic ultrasound
• pancreatic lesions
• percutaneous

The role of endoscopic ultrasound (EUS) in the last two decades has shifted from a diagnostic tool to an important therapeutic tool treating mainly pancreato-biliary disorders. In recent years, its applications for treating pancreatic diseases have broadened, including the implementation of radiofrequency ablation (RFA), which has been traditionally used for treating solid tumors. In this critical in-depth review, we summarized all the papers throughout the literature regarding EUS-RFA for pancreatic neuroendocrine neoplasms, adenocarcinoma, and pancreatic cystic lesions. Overall, for pancreatic neuroendocrine neoplasms we identified 16 papers that reported 96 patients who underwent EUS-RFA, with acceptable adverse events that were rated mild to moderate and a high complete radiological resolution rate of 90%. For pancreatic adenocarcinoma, we identified 8 papers with 121 patients. Adverse events occurred in 13% of patients, mostly rated mild. However, no clear survival benefit was demonstrated. For pancreatic cystic lesions, we identified 4 papers with 38 patients. The adverse events were mostly mild and occurred in 9.1% of patients, and complete or partial radiological resolution of the cysts was reported in 36.8%. Notably, the procedure was technically feasible for most of the patients. Nevertheless, a long road remains before this technique finds its definite place in guidelines due to several controversies. EUS-RFA for pancreatic tumors seems to be safe and effective, especially for pancreatic neuroendocrine neoplasms, but multicenter prospective trials are needed to consider this treatment as a gold standard.

• Endoscopic ultrasound
• Radiofrequency ablation
• Efficacy
• Safety
• Pancreas
• Tumors

• Humans
• Pancreatic Neoplasms/diagnostic imaging
• Pancreatic Neoplasms/surgery
• Pancreatic Neoplasms/pathology
• Adenocarcinoma
• Prospective Studies
• Ultrasonography, Interventional
• Radiofrequency Ablation/adverse effects
• Radiofrequency Ablation/methods
• Neuroendocrine Tumors/diagnostic imaging
• Neuroendocrine Tumors/surgery
• Neuroendocrine Tumors/pathology
• Pancreatic Cyst/diagnostic imaging
• Pancreatic Cyst/surgery
• Pancreatic Cyst/pathology
• Multicenter Studies as Topic

• Endoscopic ultrasound-guided fine-needle aspiration
• Endoscopic ultrasound-guided fine-needle biopsy
• Franseen needle
• Microsatellite instability
• Pancreatic neoplasms

• EUS
• FNA
• cyst
• infection
• pancreas

• EUS
• chromoendoscopy
• colon capsule
• confocal laser endomicroscopy
• endoflip
• endoscopy
• optical coherence tomography
• pediatric
• therapeutic endoscopy
• wireless motility capsule

• Artificial intelligence
• Convolutional neural network
• Deep learning
• Endoscopic ultrasonography
• Gastrointestinal stromal tumor
• Leiomyoma

Over the past 40 years, endoscopic ultrasound (EUS) has become a safe and effective tool for both diagnostic and therapeutic applications. A growing number of articles have been published annually. We aimed to explore global scientific outputs and hotspots of EUS published by different countries, organizations, and authors.

The global literature regarding EUS during the 1900–2020 period was identified from the Web of Science (WOS) Core database. “Bibliometrix” and software VOSviewer were applied to perform bibliometric analysis.

The annual growth rate of publications from 1980 to 2020 was around 16% and the number of EUS-related articles had experienced a sudden increase in the last decade. Bhutani MS was the most productive author over the past years, with 94 publications. Hawes RH had the highest number of citations, with 6,034 citations. The United States and institutions from United States dominated the EUS research. Among the journals, GASTROINTESTINAL ENDOSCOPY published the highest number of articles, followed by ENDOSCOPY. The majority of top 10 frequently cited references were cited more than 200 times. Carcinoma, diagnosis, fine-needle-aspiration, cytology, and pancreatitis were the important keywords in co-occurrence analysis of keywords. Recent studies focused more on tissue acquisition, size of the needle, lumen-apposing metal stent, and fine-needle- biopsy.

Research on EUS has significantly increased in the last decade globally and it will continue to increase. Active collaboration among different authors and countries was observed in the EUS field. Tissue acquisition, size of the needle, apposing metal stent, and fine-needle-biopsy might be the latest research frontiers and should receive more attention.

• VOSviewer
• bibliometric analysis
• bibliometrix
• endoscopic ultrasound
• gastroentergology

Endoscopic ultrasonography‐guided tissue acquisition (EUS‐TA) is now an established technique to obtain the pathological diagnosis of solid pancreatic lesions (SPLs), but the diagnosis of small SPLS by EUS‐TA can still be difficult. We conducted a literature review and a meta‐analysis on the diagnostic yield of EUS‐TA according to the tumor size. In a meta‐analysis of 33 studies with 6883 cases, a pooled odds ratio (OR) of sensitivity was significantly higher in SPLs of >20 mm (OR 1.64, p = 0.02) and in SPLs of >10 mm (OR 3.05, p = 0.01), but not in SPLs of >30 mm (OR 1.18, p = 0.46). The meta‐analysis of accuracy also showed a similar trend: OR of 1.59 in SPLs of >20 mm (p < 0.01) and OR of 3.27 in SPLs of >10 mm (p < 0.01) and OR of 1.03 in SPLs of >30 mm (p = 0.87). The use of a 25‐gauge needle tended to improve sensitivity in small SPLs, though not statistically significant: OR of 1.25 and 2.82 in studies with and without a 25‐gauge needle (p = 0.08). The use of fine needle biopsy needles, slow pull method, and rapid on‐site evaluation did not significantly improve sensitivity in small SPLs. EUS‐TA for small SPLs, especially neuroendocrine neoplasms, is reported to have a high risk of adverse events. In summary, the diagnostic yield and safety of EUS‐TA for small (<20 mm) SPLs still needs improvement, and the best needle and technique for small SPLs should be further investigated.

• adverse event
• bleeding
• needle tract seeding
• pancreatitis

The differential diagnosis between benign and malignant lymph nodes (LNs) has a fundamental role in the characterization and staging of malignant conditions, as well as in subsequent patients’ management. All imaging modalities (i.e. computed tomography and magnetic resonance imaging) rely mainly on size; endoscopic ultrasound (EUS) criteria based on B-mode evaluation and Doppler features fail to adequately characterize with high specificity LNs nature. The introduction of EUS-elastography and contrast-enhanced harmonic EUS are useful techniques to increase the diagnostic yield in identifying metastatic LNs, to identify which suspicious LN should require pathological characterization and, finally, to target tissue acquisition. EUS-guided tissue acquisition (EUS-TA) is increasingly being used for diagnosing lymphadenopathy whenever the characterization modifies patients’ subsequent management and when no superficial LN is accessible. Since target therapy are currently available (i.e. lung cancer, breast cancer), EUS-TA of malignant LNs could be required to identify tumor biology. In this field, both fine needle aspiration and biopsy needles are able to guarantee accurate results with almost perfect specificity and sub-optimal sensitivity. We finally propose a diagnostic algorithm based on most recent, high-level evidence for the diagnostic approach to suspected LNs assessment.

• Endoscopic ultrasound-guided tissue acquisition
• Endoscopic ultrasound-fine needle aspiration
• Endoscopic ultrasound-fine needle biopsy
• Biopsy
• Aspiration
• Cancer

Artificial intelligence (AI), particularly the deep learning technology, have been proven influential to radiology in the recent decade. Its ability in image classification, segmentation, detection and reconstruction tasks have substantially assisted diagnostic radiology, and has even been viewed as having the potential to perform better than radiologists in some tasks. Gastrointestinal radiology, an important subspecialty dealing with complex anatomy and various modalities including endoscopy, have especially attracted the attention of AI researchers and engineers worldwide. Consequently, recently many tools have been developed for lesion detection and image construction in gastrointestinal radiology, particularly in the fields for which public databases are available, such as diagnostic abdominal magnetic resonance imaging (MRI) and computed tomography (CT). This review will provide a framework for understanding recent advancements of AI in gastrointestinal radiology, with a special focus on hepatic and pancreatobiliary diagnostic radiology with MRI and CT. For fields where AI is less developed, this review will also explain the difficulty in AI model training and possible strategies to overcome the technical issues. The authors’ insights of possible future development will be addressed in the last section.

• Artificial intelligence
• Deep learning
• Image diagnosis
• Radiology
• Magnetic resonance imaging
• Computed tomography

Endoscopic ultrasound-guided fine needle aspiration or biopsy (EUS-FNA or FNB) has become a popular method for diagnosing various lesions of the gastrointestinal tract and surrounding tissue due to the accuracy and safety. To the best of our knowledge, no case report of severe infection after EUS-FNB of a solid lesion in the spleen has been described. Herein, we report a rare case of septic shock after EUS-FNB of a splenic mass.

A 45-year-old male patient presented to the outpatient clinic due to an incidentally detected splenic mass. A definitive diagnosis could not be established based on the abdominal magnetic resonance imaging. EUS of the spleen showed a 6 cm-sized, relatively well-demarcated, heterogeneous mass, and EUS-FNB with a 22G needle was performed. Ten days after the procedure patient developed septic shock and a splenic abscess was identified. Blood culture revealed growth of Granulicatella adiacens. After the treatment with antibiotics the patient underwent surgical resection, and the pathological examination showed diffuse large B-cell lymphoma. The patient received chemotherapy and he is in complete remission.

Infection of a splenic mass after EUS-FNB is a rare complication and prophylactic antibiotics might be considered.

• Endoscopic ultrasound
• Endoscopic ultrasound-guided fine needle biopsy
• Splenic neoplasms
• Lymphoma
• Septic shock
• Case report

• Carnobacteriaceae
• Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects
• Humans
• Image-Guided Biopsy
• Male
• Middle Aged
• Shock, Septic/etiology
• Splenic Diseases/diagnostic imaging
• Splenic Diseases/etiology

EUS is frequently utilized for tissue acquisition in adult patients. However, the literature is limited regarding the utility of EUS-guided fine-needle aspiration or biopsy (FNA or FNB) in children. In this study, we aim to evaluate the feasibility, safety, and diagnostic utility of EUS-FNA/FNB in children with various gastrointestinal diseases.

The data of children (≤18 years) who underwent EUS-FNA/FNB from March 2014 to June 2020 were analyzed, retrospectively. The following parameters were analyzed: technical success, adverse events, and impact on the final diagnosis.

Sixty-seven children (32 – boys, 14.8 ± 2.9 years, range 8–18 years), underwent EUS-guided tissue acquisition procedures using standard therapeutic echoendoscope during the study period. The indications included solid pancreatic lesions in 29 (43.3%), mediastinal or abdominal lymphadenopathy in 30 (44.7%), cystic pancreatic lesions in 5 (7.5%), subepithelial lesions in 2 (3%), and retroperitoneal mass in 1 (1.5%). EUS-FNA and-FNB were performed in 42 and 25 children, respectively. All the procedures could be successfully performed and there was no major procedure-related adverse event. Minor adverse events included self-limiting throat pain (10) and abdominal pain (3), self-limited bleeding at puncture site (3), and transient fever (1). EUS-FNA/FNB provided a histopathological diagnosis in 59 (88.1%) children.

EUS-guided tissue acquisition using standard echoendoscope is feasible and safe in the pediatric age group. EUS-FNA/FNB establishes diagnosis in majority of the children when performed for appropriate clinical indication.

• EUS
• fine-needle aspiration
• fine-needle biopsy

• Accuracy
• Endoscopic ultrasound fine needle biopsy
• 
Save passes
• 
visual evaluation of specimen

• 25G ProCore™
• EUS-guided fine needle aspiration
• mass
• pancreas

• gastrointestinal cancer
• near-infrared spectroscopy
• cancer imaging

• Female
• Gastrointestinal Neoplasms/diagnostic imaging
• Gastrointestinal Neoplasms/surgery
• Gastrointestinal Stromal Tumors/diagnostic imaging
• Gastrointestinal Stromal Tumors/surgery
• Humans
• Hyperspectral Imaging
• Machine Learning
• Male

• The National Cancer Center Research and Development Fund

• bleeding
• complications
• endoscopic ultrasound-guided fine-needle aspiration
• infection
• morbidity
• mortality
• needle tract seeding
• pancreatitis
• perforation

Type 1 autoimmune pancreatitis (AIP) is histologically characterized by lymphoplasmacytic sclerosing pancreatitis (LPSP). Recently, the diagnostic yield of endoscopic ultrasonography-guided fine needle aspiration/biopsy (EUS-FNA/B) for AIP has been reported. However, its role in the diagnostic flow of AIP is not fully elucidated. We retrospectively reviewed 53 consecutive patients who were suspected with AIP and underwent EUS-FNA/B. We evaluated the contribution of EUS-FNA/B to the diagnosis of AIP before considering response to steroid therapy among patients with diffuse enlargement of the pancreas and those with focal enlargement, respectively. Twenty-two patients showed diffuse pancreatic enlargement and 31 showed focal enlargement. The final diagnosis was definitive AIP in 32 patients, probable AIP in 2, possible AIP in 1, and mass-forming focal pancreatitis in 18. There was no change in diagnosis after EUS-FNA/B among patients with diffuse pancreatic enlargement, while diagnosis changed in 38.7% (12/31) among those with focal enlargement—there was a probable to definitive diagnosis in 4 patients, unspecified to definitive in 3, and unspecified to probable in 5. EUS-FNB provided a significantly higher sensitivity for typical pathological findings of LPSP than EUS-FNA, and 10 patients were diagnosed as pathologically definitive AIP by EUS-FNB, though none were by EUS-FNA (p = 0.002). EUS-FNA/B was useful in the diagnosis of focal type AIP, and steroid therapy could be introduced after the diagnosis was confirmed. Meanwhile, EUS-FNA/B provided no contribution to diagnosis of diffuse type AIP. EUS-FNB showed a higher diagnostic yield than FNA.

• autoimmune pancreatitis
• diagnosis
• endoscopic ultrasonography
• fine needle aspiration/biopsy

The efficacy of immune checkpoint blockade in the treatment of microsatellite instability (MSI)-high tumors was recently reported. Therefore, the acquisition of histological specimens is desired in cases of unresectable solid pancreatic lesions (UR SPLs). This study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for UR SPL tissue acquisition and MSI evaluation.

A total of 195 SPL patients who underwent EUS-guided fine-needle aspiration (EUS-FNA) or EUS-FNB (EUS-FNAB) between January 2017 and March 2020 were enrolled in this study. Among them, 89 SPL patients (FNB: 28, FNA: 61) underwent EUS-FNAB using a 22-G needle (UR SPLs: 58, FNB: 22, FNA: 36) (UR SPLs after starting MSI evaluation: 23, FNB: 9, FNA: 14).

The puncture number was significantly lower with FNB than with FNA (median (range): 3 (2–5) vs 4 (1–8), P <  0.01, UR SPLs: 3 (2–5) vs 4 (1–8), P = 0.036). Histological specimen acquisition was more commonly achieved with FNB than with FNA (92.9% (26/28) vs 68.9% (42/61), P = 0.015, UR SPLs: 100% (22/22) vs 72.2% (26/36), P <  0.01). The histological specimen required for MSI evaluation was acquired more often with FNB than with FNA (88.9% (8/9) vs 35.7% (5/14), P = 0.03).

EUS-FNB using a Franseen needle is efficient for histological specimen acquisition and sampling the required amount of specimen for MSI evaluation in UR SPL patients.

• EUS-FNA
• EUS-FNB
• Microsatellite instability
• Unresectable pancreatic lesion

• Animals
• Cysts/diagnostic imaging
• Equipment Design
• Intestines/diagnostic imaging
• Metals, Heavy/chemistry
• Models, Biological
• Phantoms, Imaging
• Swine
• Transducers
• Ultrasonography, Interventional/instrumentation
• Ultrasonography, Interventional/methods

• Adverse Events
• Endoscopy
• Infection
• Prophylaxis

• Magnetic resonance imaging (MRI)
• computed tomography (CT)
• endoscopic ultrasound
• pancreatic cancer
• positron emission tomography (PET)

• Fiberoptic
• Fusion splice joint
• Laser therapy
• Microneedle
• Needle insertion force
• Pancreatic cancer therapy

Pancreatic cancer (PC) is among the most lethal malignancies due to an often delayed and difficult initial diagnosis. Therefore, the development of a novel, early stage, diagnostic PC marker in liquid biopsies is of great significance. In this study, we analyzed the differential glycomic profiling of extracellular vesicles (EVs) derived from serum using lectin microarray. The glyco-candidates of PC-specific EVs were quantified using a high-sensitive exosome-counting system, ExoCounter. An absolute quantification system for altered glycan-containing EVs elevated in PC serum was established. EVs recognized by O-glycan-binding lectins ABA or ACA were identified as candidate markers by lectin microarray. Quantitative analyses using ExoCounter revealed that the ABA- or ACA-positive EVs were significantly increased in the serum of PC patients. These specific EVs with O-glycans can act as potential biomarkers in a liquid biopsy for PC patients screening.

Pancreatic cancer (PC) is among the most lethal malignancies due to an often delayed and difficult initial diagnosis. Therefore, the development of a novel, early stage, diagnostic PC marker in liquid biopsies is of great significance. In this study, we analyzed the differential glycomic profiling of extracellular vesicles (EVs) derived from serum (two cohorts including 117 PC patients and 98 normal controls) using lectin microarray. The glyco-candidates of PC-specific EVs were quantified using a high-sensitive exosome-counting system, ExoCounter. An absolute quantification system for altered glycan-containing EVs elevated in PC serum was established. EVs recognized by O-glycan-binding lectins ABA or ACA were identified as candidate markers by lectin microarray. Quantitative analyses using ExoCounter revealed that the ABA- or ACA-positive EVs were significantly increased in the culture of PC cell lines or in the serum of PC patients including carbohydrate antigen 19-9 negative patients with high area under curve values. The elevated numbers of EVs in PC serum returned to normal levels after pancreatectomy. Histological examination confirmed that the tumors stained with ABA/ACA. These specific EVs with O-glycans recognized by ABA/ACA are elevated in PC sera and can act as potential biomarkers in a liquid biopsy for PC patients screening.

• O-glycan
• extracellular vesicles
• glycomics
• lectin microarray
• liquid biopsy
• pancreatic cancer

• Endoscopic ultrasound
• adverse events
• diagnostic
• intervention
• mortality

The mainstay for the definitive diagnosis of pancreatic lesions is endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). However, there is evidence that EUS-FNA has low sensitivity in the setting of chronic pancreatitis (CP). This single-center retrospective study aimed to compare and analyze the diagnostic yield of EUS-FNA for solid pancreatic lesions in the presence and absence of CP, and to further investigate strategies for overcoming the low diagnostic yield in the setting of CP.

This study identified patients who underwent EUS-FNA at Sanford USD Medical Center (SD, USA) for a solid pancreatic lesion between July 15, 2011, and November 30, 2017. Data on demographics, clinical features, cross-sectional imaging findings, EUS findings, cytology/pathology, and clinical follow up were collected.

The final diagnosis was adenocarcinoma in 156 patients (67%), neuroendocrine tumor in 27 (12%), lymphoma in 6 (3%), metastatic malignancy in 8 (4%), and benign etiologies in 35 (15%). CP was identified in 44/234 (19%) patients. The overall diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for EUS-FNA were 92.9%, 97.1%, 99.5%, 70.8%, and 93.5%, respectively. The sensitivity (80% vs. 95%, P=0.020) and accuracy (86% vs. 95%, P=0.043) were significantly lower in patients with CP compared to those without CP.

CP can significantly affect the EUS-FNA diagnostic yield of solid pancreatic neoplasms. A high index of clinical suspicion is required in these cases to make a definitive diagnosis.

• Chronic pancreatitis
• endoscopic ultrasound-guided fine-needle aspiration
• pancreatic adenocarcinoma
• solid pancreatic lesion

• endoscopic ultrasound-guided fine-needle aspiration
• gastrointestinal stromal tumor
• gastrointestinal subepithelial lesion
• leiomyoma
• needle-based confocal laser endomicroscopy

• Direct Comparison
• Fluid Collection
• Outcome
• Risk Factor

• endoscopic ultrasound
• gastric subepithelial lesions
• needle-based confocal laser endomicroscopy
• real-time diagnosis

• Biopsy
• Complication
• EUS
• Pancreas
• meta-Analysis

EUS-guided tissue acquisition (EUS-TA) has made rapid development since its introduction in the early 1990s. The technique is widely accepted and invaluable for staging and diagnosis of a variety of upper gastrointestinal and mediastinal lesions. Fine-needle aspiration (FNA) has long been the gold standard, but due to its limitations such as the inability to retain stroma and associated cellular architecture, novel biopsy needles (FNB) were designed. Overall, FNA and FNB needles perform seemingly equally in terms of diagnostic accuracy, however, the second-generation FNB needles require less passes. The third-generation FNB needles (crown-cut needle types) seem to be preferable to FNA needles as well as to the second-generation FNB needles, when larger histological specimens and preserved tissue architecture are required. EUS-TA is constantly under development, and new applications of this technique include tumor risk stratification according to its genetic profile as well as minimally invasive creation of patient-derived organoids, hallmarks of personized medicine. It remains yet to be shown, whether these applications will lead to a decisive shift from aspiration to biopsy, i.e., from A to B.

• EUS
• FNA
• fine-needle biopsy
• pancreas

• Diagnosis
• endoscopic ultrasound-guided fine needle aspiration
• lymphadenopathy
• meta-analysis

Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is preferred for sampling of lymph nodes (LNs) adjacent to the gastrointestinal wall; however, fine-needle biopsy (FNB) may provide improved diagnostic outcomes. This study aimed to evaluate the comparative efficacy and safety of FNA versus FNB for LN sampling.

This was a multicenter retrospective study of prospectively collected data to evaluate outcomes of EUS-FNA and EUS-FNB for LN sampling. Characteristics analyzed included sensitivity, specificity, accuracy, the number of needle passes, diagnostic adequacy of rapid on-site evaluation (ROSE), cell-block analysis, and adverse events.

A total of 209 patients underwent EUS-guided LN sampling. The mean lesion size was 16.22±8.03 mm, with similar sensitivity and accuracy between FNA and FNB ([67.21% vs. 75.00%, respectively, p=0.216] and [78.80% vs. 83.17%, respectively, p=0.423]). The specificity of FNB was better than that of FNA (100.00% vs. 93.62%, p=0.01). The number of passes required for diagnosis was not different. Abdominal and peri-hepatic LN location demonstrated FNB to have a higher sensitivity (81.08% vs. 64.71%, p=0.031 and 80.95% vs. 58.33%, p=0.023) and accuracy (88.14% vs. 75.29%, p=0.053 and 88.89% vs. 70.49%, p=0.038), respectively. ROSE was a significant predictor for accuracy (odds ratio, 5.16; 95% confidence interval, 1.15–23.08; p=0.032). No adverse events were reported in either cohort.

Both EUS-FNA and EUS-FNB are safe for the diagnosis of LNs. EUS-FNB is preferred for abdominal LN sampling. EUS-FNA+ ROSE was similar to EUS-FNB alone, showing better diagnosis for EUS-FNB than traditional FNA. While ROSE remained a significant predictor for accuracy, due to its poor availability in most centers, its use may be limited to cases with previous inconclusive diagnoses.

• Endoscopic ultrasound
• Endoscopic ultrasound-guided tissue acquisition
• Fine-needle aspiration
• Fine-needle biopsy
• Lymph nodes

Recently, a 21G Menghini-type needle for EUS-guided fine-needle aspiration biopsy (EUS-FNAB) has been developed. The stylet of the EUS Sonopsy CY™ remains inside the needle during aspiration. Therefore, it is expected to obtain higher-quality histological core specimens without crushing the material or blood contamination. The aim of this study is to evaluate the feasibility and diagnostic accuracy of EUS-FNAB of solid pancreatic masses with this new biopsy needle.

A total of 30 patients with solid pancreatic masses who underwent EUS-FNAB with two different types of needles, EUS Sonopsy™ and ProCore™, were included in a prospective, randomized, controlled, crossover study. All the pancreatic masses were punctured with the two needles and were randomized regarding the order of the needle to be used. The primary outcome was to compare the diagnostic accuracy and the rates of tissue acquisition of the two needles.

The tissue acquisition rate was not significantly different between the EUS Sonopsy CY™ needle and the ProCore™ needle (78.6% vs. 82.1%, P = 1.00). The histological diagnostic accuracy was also similar between the two needles (73% vs. 80%, P = .63). There was also no difference regarding the accuracy of cytology alone and the combination of both histological and cytological assessments between the EUS Sonopsy CY™ needle and the ProCore™ needle (90% vs. 87%, P = 1.00 and 90% vs. 90%, P = 1.00, respectively).

EUS Sonopsy CY™ is a reliable device for EUS-FNAB of solid pancreatic masses.

• biopsy
• magnetic actuation
• medical robot
• soft capsule endoscope